Identifying individuals in the sex trade in healthcare settings

Common signs: 

• Is not free to leave or come and go as he/she wishes  

• Is fearful, anxious, depressed, submissive, tense, nervous/paranoid, hypervigilant

• Exhibits distrust towards the healthcare provider  

• Exhibits unusually fearful or anxious behavior when discussing security or law enforcement

• Anxiety about sexual history or work responsibilities   

• Avoids eye contact  

• Appears malnourished

• Shows signs of repeated exposure to harmful chemicals  

• Shows signs of physical and/or sexual abuse, physical restraint, confinement, or torture  

• Lacking basic needs  

• Signs of branding or “ownership” (tattoos, jewelry)  

• Excess amounts of cash or new clothing, hair, nails, style  

Lack of control:

• Few or no personal possessions   

• Not in control of their own money, financial records, or bank account  

• Not in control of their own identification documents (ID or passport)  

• Not allowed or able to speak for themselves (a third party may insist on being present and/or translating)  

• Signs of reporting to a controlling person  

• Illogical relationships (20-year-old patient with a 50-year-old present at appointment)

Other:

• Claims of just visiting and inability to clarify where they are staying/address  

• Lack of knowledge of whereabouts and/or of what city they are in  

• Loss of sense of time  

• Inconsistencies in story, signs of trauma  

• Hotel room keys, provocative clothing, sex toys, condoms

• Use of vocabulary from “the life”